Although triceps tendon tears are less common than other tendon tears, complete ruptures require surgical repair to restore the strength of the extensor mechanism of the elbow. There are several described techniques for repair using both transosseous tunnels and suture anchors. Current techniques often result in large suture knots over the dorsal ulna under thin subcutaneous tissue, which can be irritating for patients. Knotless techniques require costly suture anchors. In this technical note, we describe a novel transosseous 3-tunnel technique with proximal suture knots to lessen the potential for postoperative pain.
Purpose: To use validated outcome measures to evaluate the clinical results of surgical repair of distal triceps tendon ruptures using transosseous tunnels and high-strength sutures with proximally based knots. Methods: A consecutive series of traumatic distal triceps tendon ruptures at a single institution was studied. All cases were surgically repaired by 1 surgeon using high-strength suture with a bone tunnelebased repair technique. Repair knots were oriented proximally instead of in the traditional distal position. All patients were evaluated at long-term follow-up with a physical examination performed by the orthopaedic surgeon and the following validated outcome measures: Disabilities of the Arm, Shoulder and Hand score; Mayo Elbow Performance Score; and visual analog scale score. Results: Seven male patients with a mean age of 38 years (range, 19-50 years) and mean follow-up period of 4.1 AE 1.2 years underwent distal triceps tendon repair with bone tunnels and high-strength sutures with proximally positioned knots. Of the repairs, 4 involved the dominant arm. At final follow-up, the mean Disabilities of the Arm, Shoulder and Hand score was 1.3 AE 3.1; the mean Mayo Elbow Performance Score was 99.3 AE 1.9; and the mean visual analog scale score was 0. One additional patient who declined participation in the study had wound dehiscence and infection with an associated partial rerupture. Conclusions: This case series of triceps tendon repairs using transosseous tunnels and proximally based knots showed favorable postoperative elbow function based on validated outcome measures. Level of Evidence: Level IV, therapeutic case series.
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